Monday, November 23, 2009

US State, China Formulate Lethal Injection Drugs, Procedures

On November 13, Ohio became the first state in the United States to adopt a single-drug procedure for lethal injections. Of the 36 states with capital punishment, 35 use lethal injection (Nebraska still uses the electric chair). These states use a three-drug cocktail typically containing sodium pentothal (an anesthetic), pancuronium bromide (a paralytic agent), and potassium chloride (which stops the heart and causes death). In 2007, the Supreme Court considered whether the pending lethal injection of a Kentucky man by the three-drug protocol constituted cruel and unusual punishment. The appeal followed revelations that, in many instances, the level of sodium pentothal administered during lethal injections may not be sufficient to induce anesthesia, while the pancuronium bromide renders prisoners paralyzed, but fully awake, during cardiac arrest.

Stays of execution were issued across the country while the Supreme Court considered the case. Ultimately, in April 2008, the court ruled in that case that the three-drug procedure was in fact constitutional, but many states have remained hesitant to use the procedure. Ohio’s new plan calls for using only the first drug in the cocktail, sodium pentothal, effectively inducing a barbiturate overdose. Presumably, this new method addresses the issue of paralyzed cardiac arrest, but it raises several legal concerns as well.

First, the single drug method is untested, and this will likely produce a slew of new court challenges. Second, constitutional concerns about the death penalty rest not only on which drugs are used, but how they are administered. Because ethics rules prohibit most medical professionals from taking part in executions, lethal injections in the United States are performed by prison staff, who often lack proper training.

On September 15 of this year, Ohio was set to execute Romell Broom, who had been sentenced to death for the 1984 rape and murder of 14-year-old Tryna Middleton. Ohio Governor Ted Strickland turned down a final appeal for clemency, and the execution team proceeded to attempt to execute Broom, trying unsuccessfully for two hours to insert an IV, reportedly sticking him at least 18 times. Finally, with the team unable to find a suitable vein—though Broom even tried to help by pointing out possible veins to penetrate—the execution was halted.

Broom’s is not an isolated case. In 2006, Lewis Clark was put to death for the 1984 shooting of David Manning. The execution team struggled for more than 20 minutes to insert an IV into his arm. A few minutes into the injection, the vein collapsed and Clark reportedly raised his head and repeated, “It don’t work.” In all, it took 90 minutes from the start of the procedure until Clark was pronounced dead. In 2007, when Ohio executed Christopher Newton, it took staff so long to locate a vein that they reportedly paused to give Newton a bathroom break. Similar accounts of botched executions in many states are common.

As US states grapple with how, and if, they can make lethal injection more humane, China appears committed to replacing its own traditional method of execution—the bullet—with the needle. In a 2008 interview published in the China Daily, Jiang Xingchang, vice president of the Supreme People's Court (SPC), stated that half of China’s 404 intermediate courts, which carry out most China’s executions, already use lethal injection. He went on to say, “It is considered more humane and will eventually be used in all intermediate people's courts.” Currently, more than 30 percent of China’s population lives in areas that use lethal injection.

Unlike the United States, where each state adopts its own method of execution, including its own formula for lethal injection, lethal injection procedures in China are dictated by the Supreme People’s Court, which manufactures the drugs and distributes them to the lower courts to carry out executions. Although Dui Hua does not know the precise composition of the lethal injection administered in China (and this information is almost assuredly a state secret), anecdotal reports indicate that it is a single anesthetic injection much like that adopted in Ohio.

In an interview that appeared in the Beijing News in November 2008, Wang Jun, director of the Forensic Division of the Kunming Intermediate People’s Court, discussed his role in developing China’s first lethal injection procedure. Wang stated that he rejected numerous other drugs, including potassium cyanide, in favor of a combination of anesthetics (麻醉剂) and asserted the Supreme People’s Court adopted an essentially identical formula for national application.

Most people would agree that methods of execution that lessen the pain of death are, all else being equal, better than others. At the same time, it should not be assumed that increasingly technical methods are adopted primarily because they are humane. The paralytic second drug in the three-drug protocol, for example, freezes a victim in a mask of tranquility, which makes an execution more palatable to witness, but neither numbs pain nor hastens death. And in China, where use of prisoner organs for transplants is not forbidden by law—though a prisoner’s written consent is now required—death by lethal injection eliminates the chance that an organ will be damaged by a bullet.